High arterial pulse wave velocity is a risk factor for falls in community-dwelling older people

Objectives To examine whether arterial stiffness is a risk factor for falls in community-dwelling older people. Design Prospective cohort study. Setting Community population, Sydney, Australia. Participants Community-dwelling older adults (mean age 79.8 ± 4.4, 52.2% female; N = 481). Measurements Carotid-femoral pulse wave velocity (PWV) was measured in the supine position after lying for 10 minutes. Demographic, medical, and medication characteristics and levels of physical activity were obtained in clinical interviews and questionnaires, and falls were recorded with monthly falls diaries for 12 months. Results Participants in the top quintile of PWV (high PWV) were more likely to have higher seated systolic blood pressure (SBP) and heart rate, unsatisfactory control of blood pressure, diabetes mellitus, and lower physical activity levels. These participants were also more likely to be male and taking cardiovascular medications. Of the 473 participants available for follow-up, 212 (44.8%) reported one or more falls. In modified Poisson regression analyses, high PWV was a risk factor for falls (relative risk = 1.37, 95% confidence interval = 1.06-1.78) after adjusting for use of psychotropic and cardiovascular medications, age, sex, body mass index, seated SBP, heart rate, and diabetes status. Conclusion In community-dwelling older people, high PWV (as a measure of arterial stiffness) was a risk factor for falls after adjusting for potential demographic, anthropometric, disease, and medication confounders. Further research is required to investigate mediators for this association and the effect of lowering arterial stiffness on falls in older people.